The new exchange market seems competitive going into its second year but, even still, consumers are likely to experience some havoc when trying to determine which plan to pick.

Since the federal exchange, Healthcare.gov, and most state exchanges released plan pricing data, a number of analyses have come to similar conclusions: premiums in aggregate will be increasing modestly and in some states and major cities are actually decreasing but consumers still have to do due diligence, lest they face unexpected premium hikes because of changing benchmark plan pricing.

On average, across the largest cities in 48 states, premiums for the second lowest-cost silver plans, the benchmark plans for tax credits, are decreasing by just under one percent for 40-year-old non-smokers compared to last year, according to an analysis by the Kaiser Family Foundation. For the lowest-cost bronze plans across those cities, the average premium is increasing by about 3 percent.

That average premiums are not increasing in the double digits is certainly progress, but the variation is pretty wide and consumers will feel it.

In 22 cities, premiums for the benchmark plans are decreasing. In Phoenix, premiums are falling 10 percent, to $177 per month before subsidies, and in Denver, they’re down 15 percent, to $211 per month, according to the Kaiser Family Foundation analysis.

Consumers in Jackson, Mississippi, will see premiums for Magnolia Health Plan’s silver benchmark plan fall 25 percent — the largest decrease in any large city, albeit down from one of the highest benchmark plan premiums in a metro area last year, $410.

Meanwhile in 26 metropolitan areas, premiums for the benchmark silver plans are increasing — in some cases dramatically.

The highest increase is in Anchorage, where Moda Health’s silver benchmark plan is shooting up 28 percent, from $380 per month to $488. In Minneapolis, Blue Cross and Blue Shield of Minnesota’s benchmark plan is increasing 18 percent, although it will still be half of what Anchorage residents would pay before a subsidy and among the most affordable in the country: $183 per month.

Other metropolitan areas with benchmark plan increases include Wichita, Kansas (increasing 10 percent to $218), Oklahoma City (increasing 8.8 percent to $219), Portland, Oregon (increasing 6 percent to $213) and Charlotte, North Carolina (increasing 7 percent to $328).

To some extent, those metro-area trends reflect pricing dynamics at the state level.
In Colorado, which last year had some of the country’s highest premiums, the average across metallic tiers and rating areas are falling 8 percent, according to an analysis by the Commonwealth Fund. The average bronze plan is dropping from $308 to $280, the average silver from $368 to $345, the average gold from $455 to $392 and the average platinum from $507 to $454.

That’s all without any new competition, though it may be a sort of latent competition in action. The same 10 insurers are selling in Colorado, but selling more plans — 53 up from 44 last year.

In Minnesota, it’s a different story. Last year, Minnesota exchange goers had some of the lowest premiums, with a statewide average across metallic tiers of just $213 for a 40-year-old non-smoker, according to the Commonwealth Fund. That increased on average 19 percent this year, to $253, most markedly among bronze plans (a 21 percent increase to $212) and platinum plans (up 35 percent to $346).

One of the contributing factors in Minnesota’s exchange may be the exit of PreferredOne, the insurer that garnered the most market share — and some financial losses.

Even with those increases, Minnesota’s exchange plans are some of the most affordable in the country — but in Minnesota and elsewhere, the dynamics of auto-renewal and changing benchmark plan premiums are likely to cause confusion.

In the 34 states covered by Healthcare.gov, only 13 percent of rating areas have the same benchmark plan this year as last, according to an analysis by Avalere Health.
That means if the consumers who bought benchmark plans in the other 87 percent of regions don’t switch plans, they’ll likely be paying more in premiums based on the changing subsidies.

Last year, more than two-thirds of consumers buying through the federal exchange picked silver plans; about 40 percent of them picked the lowest-cost option and 22 percent chose the benchmark plan, according to Avalere.

In some fairly large states, few or no rating areas will have the same benchmark plan, including Florida, Illinois, New Jersey, Pennsylvania and Texas.

“The bottom line,” said Avalere Health director Elizabeth Carpenter, “is that exchange enrollees’ 2015 premiums will vary widely based on geography.”